More Midlife Women Using Cannabis to Manage Perimenopausal Symptoms

By | October 14, 2020

Recent studies suggest that the burden of menopausal symptoms is greater than generally perceived.  About 80% of women experience vasomotor symptoms (VMS) – hot flashes and night sweats — as they transition into the menopause phase.  For many, the symptoms are manageable; however, a significant proportion of midlife women experience menopausal symptoms that negatively affect sleep, mood, and overall quality of life.  

According to a study results presented during the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS), more perimenopausal women may be considering the use of cannabis for the management of their menopausal symptoms.  In a survey of 232 women (average age 56 years) participating in the Midlife Women Veterans Health Survey and living in Northern California, over half of the women reported having vasomotor symptoms (54%).  In this group of women, insomnia (27%) and genitourinary symptoms (69%) were also commonly reported.

According to this survey, 27% of the women reported that they had used, or were currently using, cannabis to help manage menopause symptoms. Another 10% reported that they were  interested in trying cannabis at some point in the future to treat their menopause problems. In contrast, only 19% of the women reported using more traditional treatments (e.g., hormone therapy) for managing menopausal symptoms. Frequency of use did not differ by age, race/ethnicity, socioeconomic status, or mental health conditions.

With the increase in availability of medical marijuana and the legalization of recreational cannabis use in many states, we are seeing an increasing number of women using cannabis to treat a wide spectrum of symptoms.  This study indicates that, even  without data to support the safety or effectiveness of cannabis in this setting, a substantial number of women with menopausal symptoms (at least in Northern California) are turning to cannabis to manage their symptoms.  

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Understandably women are concerned about turning to hormone therapy to manage their symptoms, given the findings of the Women’s Health Initiative; however, there are other, medically proven alternatives, such as SSRI and SNRI antidepressants and gabapentin.  Without adequate safety data, it is concerning that about a third of the women consider cannabis as a reasonable option for treatment. Also concerning is the fact that only 19% of the women are using traditional treatments.   

This trend parallels what we have seen with regard to the use of supplements or herbal remedies, like black cohosh, for the treatment of menopausal symptoms.  Many feel more comfortable using alternative treatments, even without data to support their effectiveness.  While “natural” implies safety to many, it is important to recognize that even treatments that are billed as being “natural” can carry risk.

Most people believe that cannabis is relatively benign; however, we don’t  really have data to support this belief, especially when used on a daily basis in older individuals or those with medical comorbidity.  Some studies have raised concerns regarding the impact of cannabis use on cognitive functioning and risk of psychiatric symptoms in older adults.  Down the road, we might consider cannabis as an option for menopausal symptoms, but first we need data to support its effectiveness and safety when used in this setting.  

Ruta Nonacs, MD PhD

Cannabis use for menopause symptom management (Medical Express)

Pot for Menopause Symptom Relief Grows in Popularity (MedPage Today)

MGH Center for Women's Mental Health